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Aguilera-Pena MP, Castiblanco MA, Osejo-Arcos V, Aponte-Caballero R, Gutierrez-Gomez S, Abaunza-Camacho JF, Guevara-Moriones N, Benavides-Burbano CA, Riveros-Castillo WM, Saavedra JM. Collet-Sicard syndrome: a scoping review. Neurosurg Rev 2023; 46:244. [PMID: 37707587 DOI: 10.1007/s10143-023-02145-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/29/2023] [Accepted: 09/02/2023] [Indexed: 09/15/2023]
Abstract
Collet-Sicard syndrome (CSS) is the unilateral palsy of the cranial nerves (CN) IX, X, XI, and XII. To our knowledge, no review describes the characteristics of patients diagnosed with CSS. Therefore, this review aims to collect and describe all cases in the literature labeled as CSS. We performed a scoping review of the literature and conducted a database search in Embase and PubMed. We included articles and abstracts with case reports or case series of patients with CSS diagnosis. We classified the cases into two groups: "CSS", referring to patients presenting exclusively with IX-XII nerve involvement, and "CSS-plus", which corresponds to cases with CSS and other neurological impairments. We included 135 patients from 126 articles, of which 84 (67.7%) were male. The most common clinical manifestations reported were dysphagia and dysphonia. The most common etiology was tumoral in 53 cases (39.6%) and vascular in 37 cases (27.6%). The majority of patients showed partial or total improvement, with just over half receiving conservative treatment. The most frequent anatomic space was the jugular foramen (44.4%) and the parapharyngeal retrostyloid space (28.9%). Approximately 21% of the patients had other CN impairments, with the seventh and eighth CN most frequently compromised. We conclude that although there is a need for greater rigor in CSS reporting, the syndrome has a clear utility in identifying the localization of jugular foramen and parapharyngeal retrostyloid space pathology.
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Affiliation(s)
| | - Maria A Castiblanco
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Valentina Osejo-Arcos
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Rafael Aponte-Caballero
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Santiago Gutierrez-Gomez
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Juan Felipe Abaunza-Camacho
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | | | - Camilo Armando Benavides-Burbano
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - William M Riveros-Castillo
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Javier M Saavedra
- Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Samaritana, Bogotá, Colombia
- Neurosurgery Department, Hospital Universitario Mayor-Mederi, Bogotá, Colombia
- School of Medicine, Universidad del Rosario, Bogotá, Colombia
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Spiegelberg M, Ermiş E, Raabe A, Tarnutzer AA. Triggered episodic vestibular syndrome and transient loss of consciousness due to a retrostyloidal vagal schwannoma: a case report. Front Neurol 2023; 14:1222697. [PMID: 37435156 PMCID: PMC10330762 DOI: 10.3389/fneur.2023.1222697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/31/2023] [Indexed: 07/13/2023] Open
Abstract
Background Various conditions may trigger episodic vertigo or dizziness, with positional changes being the most frequently identified condition. In this study, we describe a rare case of triggered episodic vestibular syndrome (EVS) accompanied by transient loss of consciousness (TLOC) linked to retrostyloidal vagal schwannoma. Case description A 27-year woman with known vestibular migraine presented with a 19-month history of nausea, dysphagia, and odynophagia triggered by swallowing food and followed by recurrent TLOC. These symptoms occurred independently of her body position, resulting in a weight loss of 10 kg within 1 year and in an inability to work. An extensive cardiologic diagnostic work-up undertaken before she presented to the neurologic department was normal. On the fiberoptic endoscopic evaluation of swallowing, she showed a decreased sensitivity, a slight bulging of the right lateral pharyngeal wall, and a pathological pharyngeal squeeze maneuver without any further functional deficits. Quantitative vestibular testing revealed an intact peripheral-vestibular function, and electroencephalography was read as normal. On the brain MRI, a 16 x 15 x 12 mm lesion in the right retrostyloidal space suspicious of a vagal schwannoma was detected. Radiosurgery was preferred over surgical resection, as resection of tumors in the retrostyloid space bears the risk of intraoperative complications and may result in significant morbidity. A single radiosurgical procedure (stereotactic CyberKnife radiosurgery, 1 x 13Gy) accompanied by oral steroids was performed. On follow-up, a cessation of (pre)syncopes was noted 6 months after treatment. Only residual infrequent episodes of mild nausea were triggered by swallowing solid food remained. Brain MRI after 6 months demonstrated no progression of the lesion. In contrast, migraine headaches associated with dizziness remained frequent. Discussion Distinguishing triggered and spontaneous EVS is important, and identifying specific triggers by structured history-taking is essential. Episodes being elicited by swallowing solid foods and accompanied by (near) TLOC should initiate a thorough search for vagal schwannoma, as symptoms are often disabling, and targeted treatment is available. In the case presented here, cessation of (pre)syncopes and significant reduction of nausea triggered by swallowing was noted with a 6-month delay, illustrating the advantages (no surgical complications) and disadvantages (delayed treatment response) of first-line radiotherapy in vagal schwannoma treatment.
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Affiliation(s)
| | - Ekin Ermiş
- Department of Radiation Oncology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Raabe
- Neurosurgery, Bern University Hospital, Bern, Switzerland
| | - Alexander Andrea Tarnutzer
- Neurology, Cantonal Hospital of Baden, Baden, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Usachev DY, Lukshin VA, Akhmedov AD, Shulgina AA, Ogurtsova AA, Pronin IN, Yakovlev SB. [Surgical treatment of cervical neurovascular bundle tumors]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2023; 87:8-20. [PMID: 37830464 DOI: 10.17116/neiro2023870518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To determine the main principles of a patient-oriented individual approach to diagnosis and surgical treatment of cervical neurovascular bundle tumors considering the capabilities of neurosurgical hospital. MATERIAL AND METHODS There were 92 patients with cervical soft tissue tumors affecting neurovascular bundle. Age of patients ranged from 9 to 81 years (mean 47). There were 65.1% women and 34.9% men. We found chemodectoma (47.4%), neurofibroma (15.8%), neurinoma (13.2%), papillary thyroid cancer (5.3%), salivary gland heterotopia (5.3%), salivary gland adenocarcinoma (5.3%), Hodgkin lymphoma (2.6%), hemangioendothelioma (2.6%) and cavernous lymphangioma (2.6%). Diagnostic algorithm included neurological examinations, Doppler ultrasound of supra-aortic arteries, transcranial ultrasound of cerebral vessels, MRI of cervical soft tissues, CT-AG, MR-AG, CT-perfusion, direct selective angiography. RESULTS A total of 94 surgical interventions were performed. All surgeries were performed using surgical optics and neurophysiological monitoring of cranial nerves IX, X, XII. We chose resection technique depending on localization, histological features and blood supply of tumor. En-bloc resection was performed in 46 cases, removal of fragments - in 23 cases, intracapsular resection of tumor followed by resection of the capsule - in 26 cases. Total and subtotal resection was performed in 68 (72%) and 23 (24%) cases, respectively. Three (4%) patients underwent partial resection of infiltrative tumors for carotid artery decompression and histological analysis. In 76% of cases, baseline symptoms of disease regressed after surgery. Persistent moderate bulbar disorders were observed in 16 patients (17%). Ischemic complications with additional surgical interventions were observed in 2 cases. CONCLUSION Patients with cervical soft tissue tumors require individual approach regarding choosing the optimal surgical treatment including possible preoperative embolization of tumor, en-bloc or intracapsular resection and carotid artery repair.
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Affiliation(s)
| | - V A Lukshin
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | | | | | - I N Pronin
- Burdenko Neurosurgical Center, Moscow, Russia
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Li L, London NR, Li S, Chen X, Carrau RL. Endoscopic Transoral Approach for Resection of Basal Cell Adenoma Arising in Parapharyngeal Space. J Neurol Surg B Skull Base 2021; 82:675-681. [PMID: 34745836 DOI: 10.1055/s-0040-1715574] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 06/11/2020] [Indexed: 02/02/2023] Open
Abstract
Objectives The clinical and radiological characteristics of the basal cell adenoma (BCA) and its association with the internal carotid artery (ICA) in the parapharyngeal space (PPS), have not been sufficiently explored. This study aims to analyze the characteristics of patients with BCA arising in the PPS and to evaluate the feasibility of a total resection via an endoscopic transoral corridor. Design and Main Outcome Measures The clinical, radiological, and histopathological characteristics of four patients with BCA arising in the PPS were retrospectively analyzed. The endoscopic transoral approach was performed for resection of BCA. Its technical nuances, perioperative comorbidities, and outcomes are introduced. Results The clinical presentation, symptoms, and signs of patients with BCA are variable. The tumor was lateral to the ICA in two patients and anterior to the ICA in the remaining two. All four BCA were successfully removed en bloc ( n = 3) or by piecemeal ( n = 1) via an endoscopic transoral approach. The ICA was not injured, and no additional nerve damage, venous bleeding, postoperative infection, or salivary gland fistula were encountered in any of the four patients. Cystic degeneration is the predominant appearance of BCA on MRI; however, they are difficult to differentiate from other lesions arising in the PPS. No recurrence was detected at the time of the study analysis. Conclusion BCA of the PPS could have variable relationships with the ICA. An endoscopic transoral approach can provide an adequate corridor for total resection of BCA in PPS with seemingly low morbidity.
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Affiliation(s)
- Lifeng Li
- Department of Otolaryngology-Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Nyall R London
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, United States.,Sinonasal and Skull Base Tumor Program, National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland, United States
| | - Shuling Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaohong Chen
- Department of Otolaryngology-Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ricardo L Carrau
- Department of Otolaryngology-Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, United States
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Arsovic E, Montava M, Fakhry N, Lavieille JP, Pacak K, Taïeb D, Varoquaux A. Quantitative biomarkers allow the diagnosis of head and neck paraganglioma on multiparametric MRI. Eur J Radiol 2021; 143:109911. [PMID: 34508941 DOI: 10.1016/j.ejrad.2021.109911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study is to identify quantitative MR biomarkers in head and neck paragangliomas. METHODS The study was approved by an institutional review board. A retrospective review of patients with head and neck paragangliomas (HNPGL) evaluated by time-resolved MRA sequences between 2009 and 2019 was performed. A control group investigated during the same period was analyzed, including nerve sheath tumors and metastatic lymph nodes from squamous cell carcinomas or undifferentiated nasopharyngeal cancer (UCNT). A gold standard was obtained for all cases. Semi-quantitative parameters of enhancement were extracted from time-intensity curves on time-resolved MRA sequences and diffusion weighted imaging/DWI was assessed for each lesion. RESULTS Sixty head and neck paragangliomas (HNPGLs) were included from 50 patients. The control group consisted of 30 parapharyngeal space lesions (27 patients), which included nerve sheath tumors (n = 12) and metastatic lymph nodes (n = 18) from squamous cell carcinomas or UCNT. PGLs showed a shorter time-to-peak value compared to other groups, measured at 25.0 +/- 29 sec. The wash-in and wash-out ratios were also significantly higher for PGLs, respectively measured at 5.34 ± 2.99 (p < 0,001) and 1.24 ± 0.80 (p < 0.001). On DWI sequences, the mean ADC value for PGLs (1.17 ± 0.19 10^-3 mm2/s) was significantly different than the other tumor groups (p < 0.001). HNPGLs were clearly distinguishable from other tumors on classification with regression tree based on TTP and ADC values. These distinct group features were also consistent on principal component analysis. CONCLUSION Our study identifies a multiparametric signature for disease subtyping, providing a strong impetus for switching from qualitative to quantitative analysis of deep soft-tissue tumors of the neck.
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Affiliation(s)
- Emina Arsovic
- Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, France
| | - Marion Montava
- Department of Head and Neck Surgery, Conception Hospital, Aix-Marseille Univ, France
| | - Nicolas Fakhry
- Department of Head and Neck Surgery, Conception Hospital, Aix-Marseille Univ, France
| | - Jean-Pierre Lavieille
- Department of Head and Neck Surgery, Conception Hospital, Aix-Marseille Univ, France
| | - Karel Pacak
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health, Bethesda, MD 20892, USA
| | - David Taïeb
- Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, France
| | - Arthur Varoquaux
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille Univ, France; Center for Magnetic Resonance in Biology and Medicine, UMR 7339, La Timone University Hospital, Aix-Marseille Univ, France.
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Matsuki T, Okamoto I, Tada Y, Masubuchi T, Fushimi C, Kamata S, Miyamoto S, Yamashita T, Miura K. Resection of Parapharyngeal Space Tumors Located in the Prestyloid Compartment: Efficacy of the Cervical Approach. Ann Surg Oncol 2020; 28:3066-3072. [PMID: 33141372 DOI: 10.1245/s10434-020-09268-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/08/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Parapharyngeal space tumors are rare. Among them, tumors in the prestyloid compartment are particularly suitable for surgery; however, there are no detailed reports of such surgery and their features remain unknown. METHODS We conducted a retrospective cohort study. For 67 surgical cases of benign tumors in this compartment, we examined the patient and tumor characteristics, fine-needle aspiration cytology (FNAC), and intraoperative details such as surgical approach, use of complete excision, and postoperative complications. RESULTS Pleomorphic adenomas (PAs) comprised 73.1% of the lesions. The diagnostic accuracy of FNAC to differentiate benign and malignant tumors was 97.7%. Of the treated lesions, 94.0% were removed via the cervical approach alone, including all PAs. The remaining 6.0% were resected via the cervical-parotid approach. The median operative time and bleeding volume were 89 min and 50 mL, respectively. Operative time using the cervical approach was significantly shorter (p = 0.021). All cases could be treated via complete surgical excision. Postoperative complications occurred in 32.8% of patients, with transient slight facial palsy being the most common. No fatal complications occurred and 92.5% of patients had no sequelae. There was no significant association between complications and surgical approach. CONCLUSION Based on diagnosis by FNAC, with a high accuracy rate, most benign prestyloid tumors, especially PAs, were resected using the cervical approach alone, with a shorter operative time and without severe complications.
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Affiliation(s)
- Takashi Matsuki
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan. .,Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Isaku Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Tatsuo Masubuchi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Chihiro Fushimi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Shinetsu Kamata
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Shunsuke Miyamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Taku Yamashita
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Kouki Miura
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
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Liu J, Sun X, Liu Q, Gu Y, Li H, Zheng C, Wang D, Fernandez-Miranda JC, Snyderman CH, Yu H. A minimally invasive endoscopic transnasal retropterygoid approach to the upper parapharyngeal space: anatomic studies and surgical implications. Int Forum Allergy Rhinol 2019; 9:1263-1272. [PMID: 31574593 DOI: 10.1002/alr.22437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/18/2019] [Accepted: 09/02/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Surgery remains the mainstay of treatment for lesions in the parapharyngeal space. However, gaining access to the parapharyngeal space is often challenging. In this study we aim to describe a minimally invasive technique of approaching the upper parapharyngeal space through an endoscopic transnasal retropterygoid approach, based on anatomic studies and surgeries. METHODS Six fresh human cadaver heads were prepared for anatomic study at the Surgical Neuroanatomy Laboratory of the Center for Cranial Base Surgery within the Department of Neurological Surgery at the University of Pittsburgh School of Medicine. Three clinical cases seen in the Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, were used to illustrate the technique and feasibility of this approach and to assess its indications, advantages, and drawbacks. RESULTS The medial pterygoid plate is the primary landmark of the endoscopic transnasal retropterygoid approach to the upper parapharyngeal space. Access to the upper parapharyngeal space could be obtained by removing the mucosa on the medial pterygoid plate and the mucosa below the pharyngeal orifice of the Eustachian tube. The 3 patients in our study tolerated the procedure well and had no serious complications after surgery. CONCLUSION The anatomic data and clinical cases in this study confirm that an endoscopic transnasal retropterygoid approach is a feasible and effective surgical treatment for selected tumors in the upper parapharyngeal space.
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Affiliation(s)
- Juan Liu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Xicai Sun
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Quan Liu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Yurong Gu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Houyong Li
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Chunquan Zheng
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Dehui Wang
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Juan C Fernandez-Miranda
- Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, CA
| | - Carl H Snyderman
- Center for Cranial Base Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Hongmeng Yu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China
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Rahpeyma A, Khajehahmadi S. Parapharyngeal Hemangiopericytoma: the Role for Mandibular Proximal Segment Replantation-Review of Literature. Indian J Surg Oncol 2019; 10:708-712. [PMID: 31857770 DOI: 10.1007/s13193-019-00975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/07/2019] [Indexed: 12/01/2022] Open
Abstract
Pharyngeal hemangiopericytoma is a rare tumor .Surgical access to space has been selected based on the location of the tumor in this space, size, and type of pathology. Hemangiopericytoma requires extracapsular dissection. Hemorrhagic nature and tight attachment to adjacent tissues are the other reasons for choosing the surgical approach with the best access. The patient was a 55-year-old female with left-sided facial swelling and dumbbell-shaped lesion involving buccal and lateral pharyngeal space. Brisk hemorrhage happened during biopsy. Submandibular incision, osteotomy of mandibular angle, and temporary proximal segment removal were done. Extracapsular dissection of the lesion performed under direct vision. Proximal segment was returned to the original location and internally fixed with miniplate. Postoperative course was without complication. Mandibular proximal segment replantation technique should be used to treat parapharyngeal tumors with a hemorrhagic tendency.
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Affiliation(s)
- Amin Rahpeyma
- 1Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,2Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- 3Dental Research Center, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran.,4Department of Oral and Maxillofacial Pathology,School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
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Wang X, Chen Y, Chen X, Xian J. Parapharyngeal space paraganglioma: distinguishing vagal paragangliomas from carotid body tumours using standard MRI. Clin Radiol 2019; 74:734.e1-734.e6. [DOI: 10.1016/j.crad.2019.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/18/2019] [Indexed: 11/30/2022]
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Matsuki T, Miura K, Tada Y, Masubuchi T, Fushimi C, Kanno C, Takahashi H, Kamata S, Okamoto I, Miyamoto S, Yamashita T. Classification of tumors by imaging diagnosis and preoperative fine‐needle aspiration cytology in 120 patients with tumors in the parapharyngeal space. Head Neck 2019; 41:1277-1281. [DOI: 10.1002/hed.25552] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 08/28/2018] [Accepted: 11/01/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Takashi Matsuki
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
- Otorhinolaryngology and Head and Neck SurgeryKitasato University Kanagawa Japan
| | - Kouki Miura
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
| | - Tatsuo Masubuchi
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
| | - Chihiro Fushimi
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
| | - Chihiro Kanno
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
| | - Hideaki Takahashi
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
| | - Shinetsu Kamata
- Department of Head and Neck Oncology and SurgeryInternational University of Health and Welfare Mita Hospital Tokyo Japan
| | - Isaku Okamoto
- Otorhinolaryngology and Head and Neck SurgeryTokyo Medical University Tokyo Japan
| | - Shunsuke Miyamoto
- Otorhinolaryngology and Head and Neck SurgeryKitasato University Kanagawa Japan
| | - Taku Yamashita
- Otorhinolaryngology and Head and Neck SurgeryKitasato University Kanagawa Japan
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A proposal for a level for parapharyngeal extension of parotid gland. Eur Arch Otorhinolaryngol 2016; 273:3455. [DOI: 10.1007/s00405-016-4226-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/19/2016] [Indexed: 11/26/2022]
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Ji SM. Difficult airway management in a patient with a parapharyngeal tumor. J Dent Anesth Pain Med 2015; 15:153-156. [PMID: 28879273 PMCID: PMC5564172 DOI: 10.17245/jdapm.2015.15.3.153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 11/15/2022] Open
Abstract
A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a 6 × 4 × 8.6 cm heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.
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Affiliation(s)
- Sung-Mi Ji
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University Hospital, Cheonan, Korea
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Transoral robotic surgery in retrostyloid parapharyngeal space schwannomas. Case Rep Otolaryngol 2014; 2014:296025. [PMID: 25202464 PMCID: PMC4151484 DOI: 10.1155/2014/296025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/14/2014] [Indexed: 11/17/2022] Open
Abstract
Parapharyngeal space (PPS) tumors are very rare, representing about 0.5% of head and neck neoplasms. An external surgical approach is mainly used. Several recent papers show how transoral robotic surgery (TORS) excision could be a prospective tool to remove mainly benign lesions in PPS; no cases of neurogenic tumors from the retrostyloid space treated with TORS have been reported. We present two cases which underwent TORS for schwannomas from the retrostyloid compartment of the parapharyngeal space. Clinical diagnosis of schwannoma was performed by magnetic resonance imaging (MRI). In the first case a 6 cm neurogenic tumor arose from the vagus nerve and in the second case a 5 cm mass from the sympathetic chain was observed. Both cases were treated successfully by the TORS approach using a new "J"-shaped incision through the mucosa and superior pharyngeal constrictor muscle. Left vocal cord palsy and the Claude Bernard Horner syndrome, respectively, were observed as expected postsurgical sequelae. In case 1 the first bite syndrome developed after three months, while no complications were observed in case 2. Both patients regained a normal swallowing function. TORS seems to be a feasible mini-invasive procedure for benign PPS masses including masses in the poststyloid space.
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